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MyGlit Jobs |  Jobs |   Hiring  for compensation Case Review Nurse (PH Registered Nurse) in Mumbai & Delhi

Hiring for compensation Case Review Nurse (PH Registered Nurse)

Gratitude Inc
344 Views
7 hours ago

Hiring for compensation Case Review Nurse (PH Registered Nurse)

1-5 Year(s)
Manila (Taguig)
Manila (Taguig)

Job Description

Key Skills

Rehabilitating Others Rescue and Emergency Equipment Medical Surgeon ward clinical experience Strong Communication Skills (Verbal and Written)) ICU/CCU nursing experience

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Job Title: Workers' Compensation Case Review Nurse (PH Registered Nurse)



Location: Onsite – Bonifacio Global City (BGC)

Shift: US Operational Hours





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About the Role



We are looking for a Philippines-registered nurse (RN) to join our growing Workers’ Compensation team. This role requires a clinical professional who will be responsible for reviewing complex workers’ compensation claims involving serious injuries and prolonged treatments. The nurse will coordinate return-to-work (RTW) plans, collaborate with multiple stakeholders (injured worker, employer, physician, attorney), and provide clinical expertise to ensure medically necessary and cost-effective care delivery.





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Key Roles & Responsibilities



Review workers’ compensation claims involving serious injuries or lengthy treatments.



Create and monitor return-to-work (RTW) plans tailored to each case.



Act as the single point of contact for injured employees throughout the claim lifecycle.



Coordinate with medical providers, employers, and attorneys to track progress and resolve barriers to care.



Assess medical reports and case files to ensure care is necessary and aligned with clinical guidelines.



Document all case management activities in the case management system accurately and thoroughly.



Communicate consistently with claims adjusters and clients to ensure medical and RTW goals are met.



Identify the need for job modifications and collaborate with employers based on employee capabilities.



Use clinical judgment to suggest alternative treatments or escalate cases to physician advisors when needed.



Evaluate ongoing treatment and update plans according to recovery progress and protocols.



Engage specialty resources (behavioral health, peer reviews, medical director) as required.



Stay current with market trends, medical treatment advances, and workers’ compensation guidelines.



Perform other duties as assigned.



 



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Required Qualifications



Bachelor’s degree in Nursing (BSN)



Active, unrestricted RN license (PRC-verified)



1–2 years of relevant clinical experience in:



Medical/Surgical Units



Orthopedics



ICU/CCU



Emergency Room



Rehabilitation





Written and verbal fluency in English



Willingness to work onsite (BGC)



Willingness to work US business hours



 



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Preferred Qualifications



Proficiency in Microsoft Office Suite: Word, Excel, PowerPoint, Visio, Project, SharePoint



Knowledge of:



Workers’ compensation regulations and practices



Case management and URAC standards



Pain management, pharmaceuticals, and rehabilitation



ODG guidelines, periods of disability, and return-to-work protocols





Strong analytical, leadership, and organizational skills



Motivational and collaborative team player



Ability to consistently meet or exceed performance metrics

Role

Customer Service Executive -Technical

Timings

US-Type Shift (Permanent)

Industry

BPO

Work Mode

Work from office

Process

Semi-Voice

Functional Area

ITES / BPO / Customer Service

Note: Myglit doesn't charge any money from candidates. If you have been asked to pay money to get this job then report to us immediately at support@myglit.com.

MyGlit Jobs |  Jobs |   Hiring  for compensation Case Review Nurse (PH Registered Nurse) in Mumbai & Delhi

Ismail Idowu

Recruiter - Gratitude Inc

NA, nigeria

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